Donaldson, L H

Hammond, N E

Smyth, K L

Agarwal, Sidharth

Taylor, Sean

Bompoint, S

Coombes, J

Bennett-Brook, K

Bellomo, R

Myburgh, J

Venkatesh, B

2024-10-08

Exploration of the incidence and outcomes of Acute Kidney Injury (AKI) broadly, and sepsis associated AKI specifically, in Aboriginal and Torres Strait Islander (First Nations) people has been limited. We compared a nested cohort of First Nations people drawn from a multinational randomised controlled trial of hydrocortisone in septic shock, to a cohort matched for age, sex and severity of illness. Acute Kidney Injury was defined using the Kidney Disease Improving Global Outcomes (KDIGO) criteria, as well as incident use of kidney replacement therapy (KRT). Major Adverse Kidney Events (MAKE) were described as the composite of death, new dialysis requirement or persisting kidney dysfunction at hospital discharge. A cohort of 57 Aboriginal and/or Torres Strait Islander patients with septic shock was identified. 91.2% (52) of the First Nations cohort met KDIGO criteria for Stage 1 AKI or greater and 63% (36) met Stage 3 criteria. 59.6% (34) of the First Nations required dialysis as compared to 45.6% (26) in the matched cohort. 60.7% (34) of First Nations participants met criteria for MAKE at hospital discharge. The proportions requiring dialysis at 6, 12 and 24 months were 8.3%, 9.1% and 6.9% respectively. The incidences of AKI and MAKE reported in this First Nations cohort are substantially higher than in previously published cohorts of patients with sepsis, even those that use sensitive definitions of AKI. Measures to promote better management of infectious diseases in First Nations communities are required.

The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia.

Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia.

The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia.

Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, St Leonards, New South Wales, Australia.

Intensive Care Unit, Royal Darwin Hospital, Northern Territory, Australia.

Intensive Care Unit, Royal Darwin Hospital, Northern Territory, Australia.

Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia.

The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia.

The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia.

The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia.

Department of Intensive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia.

Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Data Analytics Research & Evaluation Centre, The University of Melbourne and Austin Hospital, Melbourne, Victoria, Australia.

The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia.

Department of Intensive Care Medicine, St. George Hospital, Sydney, New South Wales, Australia.

The George Institute for Global Health, Faculty of Medicine, UNSW Sydney, Sydney, New South Wales, Australia.

Intensive Care Unit, Princess Alexandra and Wesley Hospitals, Brisbane, Queensland, Australia.

Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.

Nephrology (Carlton) . 2024 Oct 8. doi: 10.1111/nep.14405. Online ahead of print.

1440-1797

0000-0002-3530-785X

https://pubmed.ncbi.nlm.nih.gov/39379170/?otool=iaurydwlib

https://hdl.handle.net/10137/13719

acute renal failure (ARF)

indigenous health

sepsis

Sepsis associated acute kidney injury is common among Aboriginal and Torres Strait Islanders with septic shock and has poor outcomes: A nested cohort study.

Journal Article

Publication